Frozen Fingers, Time Is Tissue: The Prehospital Approach to Frostbite

Frozen Fingers, Time Is Tissue: The Prehospital Approach to Frostbite

Author: Ross Orpet, Paramedic turned EMS Physician April 1, 2026 Duration: 1:00:06
Frostbite is more dangerous than it looks and easier to make worse than you think. In this episode, Ross and Will sit down with Dr. Greg Doctor, a wilderness medicine specialist and emergency physician practicing in the Colorado Rockies, to break down frostbite from the prehospital perspective. Greg walks through field assessment, when to rewarm vs. when to leave it alone, pain management, and when to bypass your local ED for a tertiary care center. Whether you’re running urban calls or wilderness rescues, you may see this and this episode will help inform how you approach cold injury.   Want more? Subscribe to The Confidence Dispatch, our free weekly newsletter for paramedics who want to get 1% better every shift: →  https://loudandclear.kit.com/d45b012fae   Want to go even further? The Paramedic Confidence Builder is a year-long course and coaching community for new medics who want to close the gap between what school taught them and what the job actually demands. Not a lecture series. Not another CE you'll forget by your next shift. Real frameworks for clinical reasoning and mental performance. The stuff nobody teaches you in school. If that sounds like what you've been looking for, book a free 30-minute coaching call and we'll talk about whether it's the right fit. Even if it’s not we’ll give you actionable advice on the call so that you still walk away with something valuable: →  calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder

Stepping out of the classroom and into the rig is where the real learning begins, but that transition often leaves even seasoned providers with a lingering doubt. Loud & Clear: EMS Guiding Principles addresses that gap directly, moving past the basic protocols to explore the foundational reasoning that makes for excellent prehospital care. Hosted by Ross Orpet, a paramedic who now practices as an EMS physician, this podcast digs into the "why" behind the algorithms. It’s built on the understanding that no textbook can possibly cover every unique scenario you’ll encounter on the road. Instead of just listing steps, each episode examines the core principles that guide critical decisions when the situation doesn't fit a neat checklist. You’ll hear discussions that bridge the gap between field experience and medical rationale, focusing on the adaptive thinking required for complex emergencies. This is advanced continuing education designed for paramedics, EMTs, and all prehospital providers who feel that standard training was just the beginning. The conversations in this series aim to solidify your clinical judgment, helping you build confidence through comprehension. By tuning in, you gain access to a deeper level of professional development, where the objective is to think clearer and act more decisively, no matter how many days you have on the job. This podcast serves as a vital resource for those committed to mastering their craft beyond the basics.
Author: Language: English Episodes: 100

Loud & Clear: EMS Guiding Principles - Advanced Continuing Education for Paramedics, EMTs & Prehospital Care Providers
Podcast Episodes
Crush Injury and Crush Syndrome- Is What You Learned Folklore? [not-audio_url] [/not-audio_url]

Duration: 1:07:09
Dr. Nik Matsler is back to discuss the treatment of patients with crush injuries and crush syndrome. Dr. Matsler's insight as an emergency physician and a toxicologist are put to work helping us understand the pathophysi…
Lessons From a Sage: Interview with Jim Barrick [not-audio_url] [/not-audio_url]

Duration: 1:42:41
Jim Barrick has more than 37 years of experience in Emergency Medical Services and Helicopter Emergency Medical Services (EMS and HEMS). His humble approach makes him a wealth of wisdom for anyone in this career field. A…
Postpartum Hemorrhage- What To Do When the Bleeding Won't Stop [not-audio_url] [/not-audio_url]

Duration: 22:01
We delve into the high-stakes world of postpartum hemorrhage management with the esteemed Dr. Maria Moreira. Joins us to demystify the management of postpartum hemorrhage in the pre-hospital setting. Dr. Moreira presents…
Which is Better, Midazolam IV, IM or IN? [not-audio_url] [/not-audio_url]

Duration: 37:19
In this episode we look at a recent observational study out of the journal of neurology looking at the effectiveness of midazolam when comparing the IV vs IM vs IN routes. We'll discuss the study as well as other studies…
Non-Invasive Ventilation - Do You Understand the Physiology? [not-audio_url] [/not-audio_url]

Duration: 34:14
There are few treatments in our tool box that can have more of a positive impact than non-invasive ventilation. This episode is designed to help you better understand the physiology of how it works and how to use it more…